Aims the objectives of this study are to reveal the potential side effects after taking the covid19 vaccines, associated risk factors with severe side effects, and to compare the three COVID-19 vaccines available in Iraq (Sinopharm, AstraZeneca-Oxford and Pfizer- BioNTech). Methods a randomized cross-sectional study was conducted in April 2021. A standardized questionnaire platform was utilized to collect information about the Iraqi population. Results 1012 were enrolled in the study, 60.2% were male and 39.8% were female. 84% were symptomatic post vaccination. Young aged participants, females, participants with history of COVID19 infection, those with comorbid diseases and AstraZeneca vaccine receivers were statistically significant risk factors for having adverse reactions post vaccination, P value (0.03, 0.028, 0.007, 0.019 and 0.0001) respectively. Regarding severity of symptoms, most symptoms were mild and moderate. Residency in Kurdistan Region of Iraq and AstraZeneca vaccine were the statistically significant risk factors for getting severe symptoms P value < 0.0001 of both. Females were an associated risk factor for D-dimer elevation P value = 0.05. Conclusion fatigue, injection site reactions, fever, myalgia, headache and chills were the most reported side effects. Most symptoms were mild to moderate in term of severity.

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Introduction: This study aimed to determine first-line anti-tuberculosis drug resistance rates in new and previously treated cases and to identify risk factors associated with multidrug resistant tuberculosis (MDR-TB) at the National Reference Tuberculosis Laboratory of Iran. Methodology: This was a retrospective analysis of all confirmed TB patients from December 2000 to June 2005. Drug susceptibility testing to isoniazid, rifampicin, streptomycin, ethambutol and pyrazinamide was performed on Löwenstein-Jensen (LJ) medium according to the proportion method. Results: Mycobacterium tuberculosis strains were isolated from 1,742 patients with TB, of whom 935 (53.7%) were male. The mean age of patients was 44.2 ± 17.4 years (SD). A total of 1,074 patients were native Iranians while 668 (38.3%) were immigrant patients. Out of 1,139 (65.4%) new cases, 340 (29.9%) had at least one drug resistance. Of 603 (34.6%) previously treated cases, 416 (69.0%) had resistant strains. There were 263 patients (15.1%) with MDR-TB, 72 of whom were new (6.3% of all new cases) and 191 were previously treated (31.7% of all previously treated cases). Factors associated with MDR-TB included age under 45 years, male sex, previous TB treatment, immigration, poor living conditions, and unemployment. Conclusions: The high rate of initial resistance in MDR-TB cases and the high rate of MDR-TB in a young age group were indicators of recent transmission. Therefore, closer monitoring of transmission trends of drug resistant strains should be considered as priority, to ensure a successful TB control programme.

Introduction: On March 11, 2020, the novel coronavirus was declared a global pandemic. The disease was named COVID-19 standing for coronavirus disease 2019. The objectives were to determine the epidemiological, clinical, laboratory, and radiological characteristics of COVID-19 patients. Methods: In this prospective descriptive study, 15 confirmed hospitalized cases of COVID-19 between 18th March and April 7, 2020 were followed-up till discharge. Results: There were 15 reported patients infected by 3 imported index cases from Europe. The mean age of the patients was 28.06 (SD: 16.42 years). The patients' age stratification was as follows: 0e5 (2, 13.3%); 6e18 (2, 13.3); 19e50 (10, 66.7%), and 51e64 years (1, 6.7%). The patients were male (9, 60.0%) and female (6, 40.0%). Most of the patients had mild disease severity (13, 86.7%), followed by mild-moderate (1, 6.7%) and moderate-severe (1, 6.7%). The study revealed that 6 patients were asymptomatic, and 9 patients were symptomatic. The most common symptoms were: fever (n ¼ 8; 53.3%), cough (n ¼ 7; 46.7%), shortness of breath (n ¼ 3; 20.0%), fatigue (n ¼ 3; 20.0%), and taste and smell disorders (n ¼ 4; 26.7%). All patients were recovered and discharged over a median of 8 between 8 and 21 days. The mean and Std. deviation values of the hematological were:

This study confirms that there are significant geographical differences in the distribution of resistance-related mutations and suggests that an increased understanding of such differences in the specific distribution of resistance conferring mutations is crucial for development of new, generally applicable, molecular tools for rapid diagnosis of drug-resistant TB. The fact that a narrower distribution of mutations in high MDR-TB prevalence settings was seen suggests that much of the problems in these settings can be a result of an ongoing transmission of certain MDR-TB strains.

The prevalence of HBV and HCV co-infection among TB patients in this study was low. This may be explained by the low rate of blood transfusion among the patients, the very low prevalence of HIV infections in Kurdistan, the negative history of injection drug use, and adherence to universal infection-control measures, including vaccination for HBV. Both history of dental intervention and belonging to a Syrian population were independent risk factors for HBV/TB co-infection.

Healthcare workers (HCWs) are at increased risk of infection with Mycobacterium tuberculosis (Mtb) and, hence, of developing tuberculosis (TB) disease. The aims of this study are to identify the prevalence and determinants of latent TB infection (LTBI) among HCWs in Duhok Province. This is a cross-sectional prospective study conducted during April–July 2018 in different health care facilities of Duhok province. HCWs at multiple levels were selected by a non-systematic random sampling method. Information on demographic and associated risk factors of LTBI were collected by using a standardized questionnaire. Thereafter, all HCWs underwent QuantiFERON Gold Plus (QFT-Plus) assay. HCWs with indeterminate QFT-Plus underwent a Tuberculin Skin Test. HCWs with positive results were further evaluated by smear microscopy investigation and chest X-ray examination. Three hundred ninety-five HCWs were enrolled; 49 (12%) tested positive for LTBI. The mean age of the HCWs was 33.4 ± 9.25 with a female predominance (51.1%). According to the univariate analysis, LTBI was significantly higher among HCWs with the following: age groups ≥ 30 years, alcohol intake, ≥ 11 years of employment, high risk stratification workplaces, and medical doctors. In the multivariate analysis, the age group of 30–39 years (OR = 0.288, 95% CI: 0.105–0.794, p value = 0.016) was the only risk factor associated with LTBI. Further medical investigations did not reveal active TB cases among HCWs with LTBI. With regards to prophylactic treatment, 31 (63.3%) LTBI HCWs accepted the treatment, whereas 18 (36.7%) declined the chemoprophylaxis. Of these 31 HCWs on chemoprophylaxis, 12 (38.7%) received isoniazid (INH) for six months, 17 (54.8%) received INH in combination with rifampicin (RMP) for three months, and two (6.5%) received alternative therapy because of anti-TB drug intolerance. In conclusions, although Iraq is a relatively high TB burden country, the prevalence of LTBI among Duhok HCWs is relatively low. It is important to screen HCWs in Duhok for LTBI, particularly medical doctors, young adults, alcoholics, and those whom had a long duration of employment in high-risk workplaces. The acceptance rate of HCWs with LTBI to chemoprophylaxis was low. Therefore, ensuring medical efforts to educate the healthcare staff particularly, non-professionals are a priority to encourage chemoprophylaxis acceptance.

The objectives of this study were to determine drug resistance pattern in new and previously treated tuberculosis (TB) patients, to assess function of TB control program, and to characterize multidrug resistant TB (MDR-TB) by molecular fingerprinting methods. Anti-microbial susceptibility testing (AST) to the first line anti-TB drugs was performed on Löwenstein-Jensen (middlebrook 7H10) medium according to the proportion method. Molecular fingerprinting of all MDR strains was performed by spoligotyping and MIRU-VNTR. Mycobacterium tuberculosis strains were isolated from 53 Iraqi patients with pulmonary TB. Thirty eight patients (71.7%) tested cases, and 15 (28.3%) were previously treated. Four of the 38 new cases (10.5%) had resistant, of which 3 (7.9%) were MDR. Eight (53.3%) of the 15 previously treated patients had resistant strains, of which 7 (46.7%) were MDR. Spoligotyping of MDR strains showed CAS family (40%) as the predominant genotype. Using MIRU-VNTR typing, all isolates had a unique profile. MDR-TB prevalence is higher among previously treated patients than among the new cases. The many drug resistant strains, in absence of evidence of recent transmission and in combination with the many previously treated cases, highlight the need for an improved control program, coupled with a need to improve detection rate and early diagnosis of MDR-TB.